What is the Full Form of BSBY?

What Is BSBY? Full Form, Benefits & Eligibility Explained

The complete form of BSBY is Bhamashah Swasthya Bima Yojana. It is a health insurance scheme initiated by the Government of Rajasthan to offer high-quality medical facilities and financial security to the economically weaker segments of society. The programme is intended to make sure that no one in the state will lack medical treatment because of poor financial conditions.

Keep reading for a comprehensive overview!
 

Background and Objectives of BSBY

The Bhamashah Swasthya Bima Yojana was launched as part of the broader Bhamashah Yojana, which aims to promote financial inclusion and empower women. The health insurance programme, BSBY, specifically targets cashless medical care for eligible families in government and private empanelled hospitals.

The primary goals of BSBY are:

• Offering financial security from exorbitant medical costs.
• Lowering the out-of-pocket cost of medical care for economically weaker sections.
• Providing access to quality healthcare facilities all over the state.
• Facilitating cashless treatment for various medical ailments.
   

Key Features of BSBY

BSBY offers several features that make it an essential part of healthcare access in Rajasthan:

• Cashless Treatment: Beneficiaries can receive medical care at empanelled hospitals without paying advance fees.
• Wide Coverage: The scheme covers over 1,576 medical and surgical procedures, including cardiology, nephrology, orthopaedics, gynaecology, and cancer-related diseases.
• Sum Insured: Each family is covered up to:
  • ₹30,000 per year for general illnesses.
  • ₹300,000 per year for serious or critical illnesses.
• Empanelled Hospitals: Treatment may be received at government and private hospitals registered under the scheme.
• Paperless and Card-based: The entire process is conducted online. Beneficiaries use their BSBY card to access services, which speeds up admission and claims.
• Pre- and Post-Hospitalisation Charges: Some packages also cover diagnostic tests, pre-surgery evaluations, and post-surgery check-ups.
• Transport Allowance: The scheme also provides transport fees to the hospital, usually ranging from ₹100 to ₹200.
   

Diseases and Procedures Covered Under BSBY

BSBY covers over 1,400 medical procedures across various specialities. Here’s a categorised snapshot:

Common Specialities Covered:

• General Surgery (e.g., appendectomy, hernia repair)
• General Medicine (e.g., severe infections, dengue, pneumonia)
• Orthopaedics (e.g., fractures, joint dislocations)
• ENT (e.g., tonsillectomy, sinus surgery)
• Ophthalmology (e.g., cataract surgery)
• Gynaecology & Obstetrics (e.g., standard/caesarean deliveries, hysterectomy)
• Paediatrics (e.g., neonatal care, paediatric surgeries)
• Cardiology (e.g., angioplasty, pacemaker implantation)
• Urology (e.g., prostate surgery, kidney stone removal)
• Oncology (limited cancer treatments under critical illness)
• Neurology (e.g., epilepsy management, strokes)
   

High-Cost Procedures Covered (Critical Illness List):

• Dialysis (haemodialysis and peritoneal)
• Chemotherapy & Radiotherapy (for select cancers)
• Open and Minimally Invasive Heart Surgeries (Coronary Artery Bypass Graft [CABG], valve replacements)
• Neurosurgical Interventions (e.g., brain tumour excision)
• Burns Management
• Polytrauma Management
• Organ Surgeries (e.g., nephrectomy)
   

Eligibility Criteria for Bhamashah Swasthya Bima Yojana (BSBY)

Bhamashah Swasthya Bima Yojana (BSBY) is a health insurance programme initiated by the Government of Rajasthan to provide comprehensive healthcare protection to economically disadvantaged families. To ensure that the benefits reach the intended beneficiaries, the scheme has the following eligibility criteria:
 

Residency Requirement

1. Permanent Residents of Rajasthan: The BSBY scheme is exclusively available to individuals who are permanent residents of Rajasthan.
    

Identification Documents

1. Aadhaar Card: Applicants must have an active Aadhaar card as proof of identification.​
2. Jan Aadhaar Card: This card is required for registration in the scheme and also serves as an identity for a single family. ​
    

Economic Status

1. Low-Income Families: Primarily, the scheme targets families from economically weaker sections. Typically, eligibility is determined by income criteria set by the state government.
    

Family Composition

1. Single-Family Floater Policy: BSBY offers a floater policy that covers all eligible family members. There is no maximum or minimum age for coverage, and any family members can be included.
    

Exclusions

1. Non-Residents: Non-permanent residents of Rajasthan are not eligible for the scheme.
2. Ineligible Income Groups: Families whose income exceeds the limit set by the state government do not qualify for the scheme.​
3. Incomplete Documentation: Individuals who fail to provide the necessary documents during enrolment will be deemed ineligible.
    

Application Process Of BSBY

Enrolment in BSBY occurs offline to ensure inclusivity:

1. Visit Network Hospitals: Eligible individuals should visit any network hospital in Rajasthan.​
2. Help: Support staff at these hospitals assist applicants in completing the enrolment form and submitting supporting documents.
3. Required Documents:

• Aadhaar Card​
• Jan Aadhaar Card​
• Rajasthan domicile proof​
• Photograph of the beneficiary​
• National Food Security Act (NFSA) or Rashtriya Swasthya Bima Yojana (RSBY) beneficiary card (if applicable)
  ​

Claim Process of BSBY

The claim procedure under BSBY is simplified for beneficiaries:​

• Identification: Bring the Bhamashah Card and an ID to a network hospital.​
• Authorisation: The hospital contacts the insurance company to approve the treatment amount.
• Treatment and Billing: Receive the required treatment. The hospital bills and reports are sent to the government.
• Settlement: The respective authorities settle the claim directly with the hospital, ensuring cashless treatment for the beneficiary. ​
   

The Bhamashah Swasthya Bima Yojana (BSBY) is an initiative by the Rajasthan government aimed at universal health coverage. It not only provides financial protection to the economically weaker sections but also fosters timely and quality healthcare. With its digital platform, extensive coverage, and cashless facilities, BSBY serves as a model for state-sponsored health insurance schemes in India.

So, if you fall within the eligibility criteria, apply now to safeguard your health and that of your loved ones.

Also Read:

→ Who is Eligible for Karunya Insurance

→ What are the Benefits of Swasthya Bima Yojana

→ How to Apply for Aarogyasri in Telangana

→ Who is Eligible for Bima Yojana

→ What is the Limit of the Ayushman Card